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Minimally Invasive Spine Surgery and Posterolateral Endoscopic Discectomy Gabriele Jasper, M.D. Anesthesiologist Interventional Pain Physician Center for.

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Presentation on theme: "Minimally Invasive Spine Surgery and Posterolateral Endoscopic Discectomy Gabriele Jasper, M.D. Anesthesiologist Interventional Pain Physician Center for."— Presentation transcript:

1 Minimally Invasive Spine Surgery and Posterolateral Endoscopic Discectomy Gabriele Jasper, M.D. Anesthesiologist Interventional Pain Physician Center for Pain Control Brick, NJ Milltown, NJ

2 Common Indications- Posterolateral Endoscopic Discectomy 1.A patient with back pain and/or radicular pain who has failed conservative treatment 2. Any herniation accessible endoscopically (directly proportional to experience) 3. Patient who refuses open surgery 4. Discogenic Pain 5. Discitis

3 Contraindications - Endoscopic Spine Any pathology not accessible from the posterolateral endoscopic approach –Severe central canal stenosis Inadequate support staff or equipment to successfully perform procedure Uncooperative patient Instability

4 Surgical Approach Kambin’s Triangle Exiting Nerve Endplate Transversing Nerve Root

5 MRI with HNP and Facet Hypertrophy Neuroforaminal Stenosis T2 sagittal MRI showing HNP, left L4-L5 with compression of L5 nerve root T2 axial MRI showing HNP left L4-L5 with compression of L5 nerve root

6 The Inside Out Technique The Outside Inside Technique

7 Disc Approaches

8 The Endoscopic Approach Surgical approach The interventional pain approach The modified surgical/interventional pain approach

9 Surgical Approach

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12 Interventional Pain Approach

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14 Endoscopic HydroDiscectomy Instrumentation SpineJet ® EndoResector

15 Endoscopic Discectomy with Foraminotomy and Annuloplasty

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19 Defect Created By the EndoResector

20 Pre-op Orders 1.Standard Pre-op Orders 2.Ancef 1gm I.V. or Gentamycin 3. All solutions that enter the disc need to have 10% antibiotic

21 Post-operative Orders 1.Follow-up one week 2. Back Brace during activity for six weeks 3.No work 1-2 weeks (depends on type of work) 4.No heavy lifting until re-evalution 5.Pain Medication

22 Questions ??

23 Thank You


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